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   2021| October-December  | Volume 13 | Issue 4  
    Online since November 30, 2021

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Clinical profile and immediate outcome of multisystem inflammatory syndrome in children associated with COVID-19: A multicentric study
Geetanjali Sethy, Bibhudatta Mishra, Mukesh Kumar Jain, Sibabratta Patnaik, Reshmi Mishra, Jyoti Ranjan Behera, Bandya Sahoo, Narendra Behera
October-December 2021, 13(4):159-163
Introduction: Following an asymptomatic or mildly symptomatic coronavirus disease (COVID-19), otherwise healthy children may develop serious manifestations in the form of cardiac, neurological, respiratory, gastrointestinal, and dermatologic dysfunction. Many such cases were being observed in Odisha, an eastern state of India, and have been reported from different health-care facilities. We related these unexplained serious manifestations to multisystem inflammatory syndrome associated with COVID-19 (MIS-C) and planned this study. Methods: This retrospective observational study was carried out at the following three tertiary care centers: Kalinga Institute of Medical Sciences, Bhubaneswar; MKCG Medical College, Berhampur; and Jagannath Hospital, Bhubaneswar. The study population included all children aged from 1 month to 18 years admitted to the hospitals with MIS-C according to the WHO diagnostic criteria. All the data were analyzed by SPSS software. Results: A total of 21 children were included in our study. Majority of the cases were male (76.2%), and the predominant age group was 6–10 years (47.6%). Common symptoms and signs in our observation included fever, pain abdomen, seizure, and hypotension. Most of these cases were positive for severe acute respiratory syndrome coronavirus antibody (80.95%). Response to immunotherapy was dramatic. Mortality (9%) of our study was higher than 1.8%–3% from that of Western literature. None of our patients had coronary abnormality, while two patients had mild cardiac dysfunction at discharge comparable to that of other studies. Conclusion: MIS-C following exposure to COVID-19 infection in children is a clinical syndrome, which needs early suspicion and appropriate intervention to prevent mortality.
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Facial nerve palsy as a neurological manifestation of COVID-19
Alfredo Santos Pinheiro Martins, Francisco Javier Fanjul Losa, Helem Haydee Vilchez Rueda, Mercedes García-Gasalla
October-December 2021, 13(4):183-185
Facial nerve palsy is the most frequent acute mononeuropathy and it is often of viral etiology, although many other causes have been identified. It has recently been described as a potential manifestation of COVID-19. We report the case of a patient with recent history of diarrhea and malaise that was admitted to the hospital presenting right facial paresis with orbicular muscle involvement. Nasopharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the real-time reverse transcription polymerase chain reaction and magnetic resonance imaging showed no structural changes. During the hospital stay, the patient showed clinical improvement, and no other symptoms were observed. This case presentation suggests a possible association between neuropathies and SARS-CoV-2 infection.
  2,541 194 -
Phylodynamic pattern of genetic clusters, paradigm shift on spatio-temporal distribution of clades, and impact of spike glycoprotein mutations of SARS-CoV-2 isolates from India
Srinivasan Sivasubramanian, Vidya Gopalan, Kiruba Ramesh, Padmapriya Padmanabhan, Kiruthiga Mone, Karthikeyan Govindan, Selvakumar Velladurai, Prabu Dhandapani, Kaveri Krishnasamy, Satish Srinivas Kitambi
October-December 2021, 13(4):164-171
Introduction: The COVID-19 pandemic is associated with high morbidity and mortality, with the emergence of numerous variants. The dynamics of SARS-CoV-2 with respect to clade distribution is uneven, unpredictable and fast changing. Methods: Retrieving the complete genomes of SARS-CoV-2 from India and subjecting them to analysis on phylogenetic clade diversity, Spike (S) protein mutations and their functional consequences such as immune escape features and impact on infectivity. Whole genome of SARS-CoV-2 isolates (n = 4,326) deposited from India during the period from January 2020 to December 2020 is retrieved from Global Initiative on Sharing All Influenza Data (GISAID) and various analyses performed using in silico tools. Results: Notable clade dynamicity is observed indicating the emergence of diverse SARS-CoV-2 variants across the country. GR clade is predominant over the other clades and the distribution pattern of clades is uneven. D614G is the commonest and predominant mutation found among the S-protein followed by L54F. Mutation score prediction analyses reveal that there are several mutations in S-protein including the RBD and NTD regions that can influence the virulence of virus. Besides, mutations having immune escape features as well as impacting the immunogenicity and virulence through changes in the glycosylation patterns are identified. Conclusions: The study has revealed emergence of variants with shifting of clade dynamics within a year in India. It is shown uneven distribution of clades across the nation requiring timely deposition of SARS-CoV-2 sequences. Functional evaluation of mutations in S-protein reveals their significance in virulence, immune escape features and disease severity besides impacting therapeutics and prophylaxis.
  2,135 562 -
Diabetic foot infection with Bacteroides pyogenes
Padmaja Ananth Shenoy, Shashidhar Vishwanath, Ravikumar Terikere Nagaraj, Barnini Banerjee, M Sunil Krishna
October-December 2021, 13(4):186-188
>Diabetic foot infections are the most common serious diabetes-related complication posing significant socioeconomic burden on the health-care system. Diabetic foot microbiota consists of polymicrobial flora with predominance of Gram-negative aerobes and anaerobes. Here, we report a rare case of diabetic foot infection by Bacteroides pyogenes, an obligate Gram-negative anaerobic bacillus which is commonly encountered in polymicrobial animal bite wound infections.
  2,429 233 -
State of the globe: Multisystem inflammatory syndrome in children – did the COVID-19 pandemic actually handle kids with kids-glove?
Vipul Gupta, Geetanjali Jindal
October-December 2021, 13(4):157-158
  1,746 543 -
Molecular characterization of resistance-nodulation-cell division efflux pump genes in multidrug-resistant Acinetobacter baumannii
Shahid Raza, Hitender Gautam, Sarita Mohapatra, Seema Sood, Benu Dhawan, Rama Chaudhry, Arti Kapil, Bimal Kumar Das
October-December 2021, 13(4):177-179
Introduction: Multidrug-resistant Acinetobacter baumannii is galloping, posing threat to tackle, and leaving us with limited options of treatment. Methods: The purpose of this study is to find the genotypic association in drug-resistant A. baumannii isolated from different sterile body fluids. Matrix-assisted laser desorption/ionization–time of flight confirmed A. baumannii isolates were taken and minimum inhibitory concentration (MIC) was determined by VITEK-2 AST system. The presence of resistance nodulation–division (RND)-efflux pump genes AdeABC-RS was detected by multiplex polymerase chain reaction. Results: Of the total 40 A. baumannii, 32 (80%) were multidrug resistant though all isolates were susceptible to Tigecycline. Similarly, 26 (81.25%) isolates were positive for RND-efflux pump genes AdeABC-RS. Discussion: RND efflux pump AdeABC-RS system plays a significant role in emerging multi drug resistant A. baumannii. Mutation in AdeS gene deciphers the role of regulatory gene. Hence, antimicrobial stewardship should be strictly followed and efflux pump inhibiting substances should be vigorously searched to bring back the era of existing antibiotics.
  1,692 227 -
Primary tuberculous mastitis
Sarbjit Mohapatra, Chiranth Gowda, Bhavna Nayal, Gabriel Rodrigues
October-December 2021, 13(4):196-197
  1,667 159 -
Pebbled trachea: A case series and literature review of tracheobronchopathia osteochondroplastica
Deepthi Sharma, Sindhu Kamath, Vishak K Acharya, Sharada Rai
October-December 2021, 13(4):180-182
We report a series of three cases diagnosed with tracheobronchopathia osteochondroplastica on bronchoscopy and computed tomography (CT) chest. Most patients were diagnosed incidentally on evaluation for chronic cough. The association of this entity with chronic bacterial infections and tuberculosis is an intriguing entity that was observed in our patients. Nodular, ulcerative, and calcific lesions in the trachea are bronchoscopic findings seen in quite a few other conditions posing diagnostic challenges. However, the classical bronchoscopic appearance with CT imaging in an appropriate clinical context can lead to an accurate diagnosis of this condition. We describe this array of cases with varying clinical presentations, their associations, and deliberate the literature reviews on this rare entity.
  1,612 167 -
A disastrous omen – Candidal pyo pneumopericardium
Rathijit Pal, Darpanarayan Hazra, Kishore Pichamuthu, Kundavaram Paul Prabhakar Abhilash
October-December 2021, 13(4):189-191
Pyo-pneumopericardium or purulent pericarditis is a rare medical entity associated with high mortality. We hereby report a rare case of a 25-years old lady with pyo-pneumopericardium, aspirated pus culture from the pericardial cavity of which grew yeast (Candida species) like organism. This patient underwent a pericardiocentesis and was initiated on generic antibiotic treatment. However, despite the best possible medical management, she succumbed to her illness. This is a rare case report from India and an addition to the already available literature.
  1,562 146 -
Cranial mycetoma: A rare case report with review of literature
Fouzia Siraj, Akanksha Malik, Sharma Shruti, KB Shankar, Swati Singh
October-December 2021, 13(4):192-195
Mycetoma is a chronic granulomatous infection caused by fungi or bacteria, known as eumycetoma and actinomycetoma, respectively. Mycetoma commonly affects young males belonging to low socioeconomic strata, usually barefooted agricultural workers. It mainly affects lower and upper limbs presenting as a painless swelling with discharging sinus. Rarely, is it encountered in the intracranial location. The diagnosis relies on the clinical presentation and identification of the etiological agents within the tissue, by histology and special stains. It is important to specify the fungal or bacterial etiology, because the treatment of each is completely different. The management of such infections is challenging and should involve early diagnosis, the use of antibacterials or antifungals, and surgical removal of the lesion. To the best of our knowledge, only seven cases of intracranial mycetoma have been reported. The present case highlights the rarity of this lesion, thereby contributing to the existing literature and presenting its diagnostic implications.
  1,522 127 -
Bacteriophages as surrogate marker for inactivation of SARS-CoV-2 by ultraviolet radiation to prevent COVID-19 transmission
Rathor Nisha, Chaudhry Rama
October-December 2021, 13(4):199-200
  1,462 172 -
COVID-19 associated facial palsy, A clinical dilemma
Shweta Pawar, Charlotte Juman, Nicholas Turner
October-December 2021, 13(4):198-199
  1,430 132 -
Thrombocytopenia in malaria: A red-herring for dengue, delaying the diagnosis of imported malaria
Sumudu Karunaratna, Dewanee Ranaweera, Harshini Vitharana, Prasad Ranaweera, Kamini Mendis, Deepika Fernando
October-December 2021, 13(4):172-176
Introduction: Fever and thrombocytopenia, often presenting features of malaria, are also the hallmarks of dengue infections. This study examines the degree and duration of thrombocytopenia in imported malaria infections in Sri Lanka and the extent to which this could provide a false trail in favor of a dengue diagnosis. Methods: The data of all confirmed malaria cases reported in Sri Lanka from 2017 to 2019 were extracted from the national malaria database. These included detailed histories, the time to malaria diagnosis, platelet counts, and in 2019, the trail of diagnostic procedures. Results: Over the 3 years, 158 malaria cases (157 imported and one introduced) were reported. Platelet counts were available in 90.5% (n = 143) of patients among whom 86% (n = 123) showed a thrombocytopenia (<150,000 cells/μl) and in nearly a third (n = 52) a severe thrombocytopenia (<50,000 cells/μl). Only 30% of patients (n = 48) were diagnosed with malaria within 3 days of the onset of symptoms, while in 37% (n = 58) it took 7 or more days. Platelet counts where significantly higher in patients who had symptoms for 7 days or more compared to those who had symptoms for <7 days (χ2 = 6.888, P = 0.009). Dengue fever was suspected first in 30% (n = 16) of the total malaria patients reported in 2019. Conclusions: Low platelet counts could delay suspecting and testing for malaria. Eliciting a history of travel to a malaria-endemic country could provide an important and discerning clue to suspect and test for malaria in such patients.
  1,148 413 -
Unexplained acute right ventricular dilatation and dysfunction in COVID-19
G Ezhilkugan, N Balamurugan, M Vivekanandan, R Ajai, Namgail Dorje
October-December 2021, 13(4):200-201
  1,086 131 -
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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008